Most people know that good nutrition matters. What fewer people realise is that the link between food, drink and health changes a lot as we age. Getting it wrong in later life can be far more serious than most families expect.
Around 1 in 10 people over 65 in the UK (roughly 1.3 million people) are malnourished or at risk of it. Most are living in their own homes, where the problem often goes unnoticed until it has already harmed their health, strength and independence.
Why nutrition changes with age
A natural drop in appetite is one of the least talked-about changes that comes with age. Doctors sometimes call it the "anorexia of ageing". It has several overlapping causes: less stomach acid, slower digestion, fewer hunger hormones, less physical activity, and changes in taste and smell that make food less appealing.
The problem is that although appetite falls, the body's needs do not. In fact, older adults need more protein and more vitamin D than younger adults, even when they are eating less overall. This gap between appetite and need is at the heart of why malnutrition is so common in later life.
The key point is this: the aim is not to eat less because appetite has dropped. It is to eat smarter. Smaller, more nourishing meals and snacks through the day often work better than three large meals.
Warning signs of poor nutrition
Malnutrition in older adults often builds slowly and quietly. These are the signs worth watching for:
• Weight loss without trying, or clothes and rings becoming loose
• A smaller appetite, or less interest in food
• Regularly skipping meals, or finding cooking too much effort
• Low energy and trouble concentrating
• Picking up infections more easily, or wounds healing slowly
If someone has lost a noticeable amount of weight over three to six months without trying, it is worth a conversation with their GP.
Hydration: the overlooked issue
Dehydration is more common, and harder to spot, in older adults than most people realise. Around 26% of older adults living at home are clinically dehydrated. The usual signals we rely on in younger people (thirst, dark urine, dry mouth) become unreliable with age.
The feeling of thirst fades a lot as we get older. That means an older person can become badly dehydrated before feeling any urge to drink. A simple drinking routine, rather than drinking only when thirsty, makes all the difference.
Important: thirst, urine colour and a dry mouth are not reliable signs of dehydration in older adults. The British Dietetic Association recommends aiming for 6 to 8 cups of fluid a day as a habit, not as a response to thirst.
What counts as fluid
Any fluid counts towards the daily total, not just water. Tea, coffee, milk, diluted juice, squash and soup all count. Water, tea, coffee (without added sugar) and milk are the best choices for the teeth, but every drink helps.
Why hydration matters
• Falls: dehydration can make blood pressure drop when standing, leading to dizziness. This is a major cause of falls
• Thinking and memory: even mild dehydration affects concentration, memory and mood
• Urinary tract infections: dehydration is a major risk for UTIs, a leading cause of hospital admission in older adults
• Kidney function: the kidneys become less efficient with age and rely on adequate fluid intake
• Constipation: one of the most common and most preventable causes in older adults
The Abney & Baker approach
Nutrition and hydration form the third of Abney & Baker's Five Pillars of Living Well at Home. Good nutrition connects to everything: muscle strength, brain health, falls prevention and the energy to stay social.
Five Pillars of Living Well at Home
Our carers are trained to spot the early signs of poor nutrition and dehydration. They notice changes, ask questions and raise concerns early, rather than waiting for problems to grow.
What to eat: practical guidance
A large UK Biobank study of 60,298 people found that those eating a Mediterranean-style diet developed dementia 23% less often than those eating less healthily. The same way of eating supports the heart, keeps muscle strong, boosts energy and helps the immune system. It is not complicated or expensive to follow.
• Vegetables, especially leafy greens (spinach, kale, broccoli)
• Fruit, especially berries (blueberries, strawberries)
• Oily fish (salmon, mackerel, sardines), at least twice a week
• Whole grains such as oats, wholemeal bread and brown rice
• Pulses such as beans, lentils and chickpeas
• Nuts, a small handful daily
• Olive oil as the main fat for cooking and dressings
• Eggs, chicken and dairy for good protein
• Red and processed meat such as bacon, sausages and deli meats
• Fried and fast food
• Sugary snacks, biscuits, cakes
• Butter and margarine (use olive oil instead)
• Ultra-processed foods such as ready meals and packaged snacks
• Sugary drinks such as fizzy drinks and juice with added sugar
Protein: a specific priority
Older adults need at least 1.0 to 1.2g of protein per kilogram of body weight a day, well above what younger adults need. This protects muscle and helps prevent frailty. For a 70kg person, that is 70 to 84g a day. Try to include a protein food at every meal, not just dinner.
Vitamin D: the supplement everyone should take
NHS guidance recommends 10 micrograms (400 IU) of vitamin D a day for all adults, especially from October to March. Anyone who is housebound or gets little sun should take it all year round. It supports muscle, bones and the immune system.
When appetite is poor
• Smaller, more frequent eating. Five or six small meals or snacks throughout the day often works better than three large meals when appetite is reduced.
• Fortify rather than restrict. Add full-fat milk, cream, cheese, olive oil, or nut butter to food. Full-fat dairy is better for older adults than low-fat versions.
• Milky drinks add both nutrition and hydration. Hot chocolate, malted drinks, milkshakes, and lassi all contribute protein, calcium, and fluid simultaneously.
• Don't drink just before meals. Drinks immediately before eating can reduce appetite. Drink mid-morning, mid-afternoon, and after meals.
• Eat with others whenever possible. People eat more when they eat together. Mealtimes shared with carers, family or friends make a real difference.
How we support nutrition and hydration as part of home care
Nutrition and hydration are part of every Abney & Baker care visit. They are not an add-on. They are a core part of how our care at home helps people stay well.
Our carers help with meal preparation, shopping, and keeping an eye on how much someone is eating and drinking. Through our flexible home care they can build this support around each person's day. They notice the early signs of poor nutrition and raise concerns quickly, rather than waiting for problems to grow.
“"He's getting stronger, his balance has improved, and he now walks outside without his sticks. He's even started working in the garden again. Recently he told me he's thinking about starting bowls again."”
Good nutrition underpins everything else we do. That includes our PREVENT+ strength and balance programme, which needs enough protein to produce lasting results. We take a whole-person approach because the pillars of health are all connected.
Nutrition self-assessment checklist
Work through this checklist to spot areas that might need attention. It is not a medical tool, but it can help focus a conversation with a GP or carer.
Nutrition & hydration self-assessment
How to use this checklist: fewer than 10 ticks, especially in the eating or hydration sections, suggests it is worth a chat with a GP. Any items you can't tick show you where to focus first.
When to seek further help
• There has been significant unintentional weight loss over the past three to six months
• Meals are being regularly skipped, or food intake has noticeably reduced
• There are recurring urinary tract infections, constipation, or unexplained dizziness on standing
• There is difficulty chewing or swallowing (ask for a GP referral to a speech and language therapist)
• A family member is worried about changes in appetite, weight, or how well the person is eating
Frequently asked questions
Concerned about nutrition or hydration?
Whether you're worried about your own eating, supporting a parent, or wondering how home care could help, we're always happy to talk. No pressure, no commitment.
To find out how we can help at mealtimes and beyond, explore our care at home services or our preventative home care, which is built around keeping people well, strong and independent for longer. You can also get in touch for a friendly, no-obligation chat.
We’re always here if you want to chat about your care options
Speak to a real person about how care at home can help you or your loved one.
